First in Africa, a Durban doctor performs cutting-edge surgery on a chronically ill patient's arteries

A doctor at Lenmed’s eThekwini Hospital and Heart Centre performed a medical first for the continent, performing a groundbreaking surgery that will revolutionise treatment for patients living with chronic conditions.

Dr. Vinesh Padayachy performed an orbital atherectomy, which sands away calcium or plaque buildup in the arteries that is difficult to remove.

A 67-year-old woman with atherosclerosis of the arteries in her extremities underwent the procedure. She also has hypertension, diabetes, and chronic kidney disease.

Padayachy described how he used the orbital atherectomy system, a device that rotates 360 degrees to cover the circumference of the vessel.

“This procedure greatly assists patients with blocked blood vessels. We send down a device that spins at high velocity, so much so that it files down the blockage down from the inside. This then widens the area in the blood vessel. Almost like a drill that creates a hole through the blockage,” he said.

According to Padayachy, the blockage was broken down into such small fragments that it was filtered through the system. The procedure was the first of its kind in Africa.

He explained that he needed specialised training from experts in the United States and that he was able to learn and understand the procedure through a series of virtual meetings.

“The wonders of modern technology,” Padayachy joked.

He explained that people with high blood pressure, high cholesterol, diabetes, and smokers were at risk for such buildup inside vessels. Age was another factor.

He added that surgeons consider other factors, such as the location and length of the blockage, before deciding whether the procedure is the best option for the patient.

Padayachy stated that the current procedure was less invasive than previous procedures.

“In the past we would go in and get across the blockage to open it with a stent which remained in the patient’s body for the rest of their life. Now we can go in and clear the blockage without leaving a stent behind,” he said.

Padayachy stated that follow-up treatment was dependent on the patient and their lifestyle changes.

“A person would have to manage their risk factors. There is no need to have the procedure again,” he said.

Padayachy explained the procedure’s benefits, saying it was minimally invasive and required less hospitalisation, resulting in faster healing and lower costs for the patient.

Padayachy described being a medical pioneer as exciting. He added that he hoped to share his knowledge with fellow surgeons in both the public and private sectors in order to ensure that patients received the best medical care possible.